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NPI Code Detail

MEDICARE: JOHN P TERRANELLA

MEDICARE: JOHN P TERRANELLA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatristNOO3649NY

General Provider Information

NPI Number : 1710148135
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHN P TERRANELLA
Provider Business Mailing Address
First Line : 2470 VICTORY BLVD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-6612
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2470 VICTORY BLVD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10314-6612
Country : US
Telephone Number : 718-983-8080
Fax Number :
Authorized Official
Title or Position : PODIATRIST
Name : JOHN P TERRANELLA
Credential :
Telephone Number : 718-983-8080
Provider Enumeration Date : 06/18/2008
Last Update Date : 06/18/2008

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Directions to “JOHN P TERRANELLA ” Practice Location

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